MEDICARE: THOMAS KIEFER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1699377507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS KIEFER

Provider Business Mailing Address
First Line	:	4036 WILMA CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-2223
Country	:	US
Telephone Number	:	513-752-0134
Fax Number	:

Provider Business Practice Location Address
First Line	:	4036 WILMA CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-2223
Country	:	US
Telephone Number	:	513-752-0314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2020
Last Update Date	:	11/15/2020

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Directions to “ THOMAS KIEFER ” Practice Location

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